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Mesothelioma: A Killer
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Asia Bird Flu Death Toll Climbs to 30
By VIJAY JOSHI
Associated Press Writer
BANGKOK, Thailand (AP) -- Vietnam confirmed a new bird flu death to bring Asia's human toll to 30 on Wednesday, while Thailand rued its flawed efforts to control the epidemic after reporting its first likely case of the virus jumping from one person to another.
The latest reported death was a 14-month-old baby in Hanoi, who became Vietnam's 20th victim. He was sickened with bird flu's typical symptoms of fever and coughing on Aug. 28 and died Sept. 5, a Vietnamese Health Ministry official said on condition of anonymity.
That announcement came a day after Thailand raised concern among health experts by reporting its first case of probable human-to-human transmission of the virus - a 26-year-old woman who became the country's 10th confirmed fatality.
Pranee Sodchuen died Sept. 20 of bird flu, probably after catching the disease while taking care of her sickened daughter Sakuntala in a hospital. The 11-year-old died Sept. 12 but was cremated before she could be tested to confirm she had bird flu.
The recent deaths in Vietnam and Thailand are part of a second wave of outbreaks since the disease first swept through the poultry stocks of much of Asia at the start of this year, killing or forcing the cull of tens of millions of birds. A total of 30 people have died.
New outbreaks of bird flu in recent months also have been reported in Malaysia, China, Cambodia and Indonesia.
Pranee is the first person believed to have contracted the disease from another human, rather than poultry. She had never come in contact with poultry and did not live with her daughter who was being raised in a village where chickens were bred.
Pranee's 32-year-old sister, who also had tended Sakuntala in the hospital, was diagnosed with bird flu Monday and is now in an isolation ward, as is her 6-year-old son. Both are listed in good condition.
Normally, people acquire bird flu from infected birds. But experts fear the bird virus will someday mutate into a form that spreads easily from one person to another, which could set the stage for a worldwide outbreak of deadly flu.
Still, international health experts said that the probable transmission of the virus from Sakuntala to Pranee looks like an isolated dead-end incident, rather than the start of a major outbreak.
"At the moment I think it's ... a one-alarm fire, not a four-alarm fire," flu expert Dr. William Schaffner said overnight at Vanderbilt University in the United States.
Separately, the World Health Organization said in a statement that "inefficient, limited human-to-human transmission" may occur on rare occasions, implying that it doesn't pose a danger of pandemic proportions.
But if it turns out that human to human transmission in Thailand "has been efficient and sustained," it "would be cause for alarm, as it might signal the start of an influenza pandemic," the WHO said.
Thailand cited its own flaws in dealing with the crisis.
Deputy Prime Minister Chaturon Chaisang told reporters that the government has not done a good job of educating poultry breeders, especially small-time farmers in rural areas, about the disease.
"The people who live in rural areas who raise chickens are not well informed and lack a sense of awareness about the dangers," Chaturon told reporters before a meeting with health and agriculture ministry officials.
Chaturon, who heads a panel on efforts to prevent the disease's spread, said government ministries had failed to work together properly on bird flu and that better coordination was "urgently needed."
He said the government has asked all 76 provincial governors to boost cooperation between public health and agriculture ministries for around-the-clock surveillance of bird flu.
© 2004 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
FDA to Study Adult Antidepressant Effects
That pediatric study - and the FDA's own internal reviews - established a link between antidepressants and children's worsened conditions. For every 100 children taking antidepressants, an extra two to three suffered heightened suicidal tendencies.
Those findings prompted federal advisers this month to push for strident black-box warnings to be added to labels for Celexa, Effexor, Luvox, Paxil, Prozac, Remeron, Serzone, Wellbutrin and Zoloft.
The FDA now will begin to consider the same question for depressed adults.
It will start by analyzing a few of the larger drug trials. Ultimately, Columbia's new analysis technique will be applied to all 234 clinical trials, representing 40,000 depressed adults.
"We'll be able to see, for adults, if this type of analysis shows any change in their thinking or expression," Woodcock said.
Already, the agency knows that depressed adults in clinical trials complete suicides at the same rate, whether they're taking antidepressants or placebos. That earlier study was driven by the ethical dilemma raised by denying drugs to depressed adults. Researchers worried about a spike in suicides among the adults taking sugar pills.
"We found that wasn't the case," Woodcock said.
An analysis already conducted by the FDA found no differences in behavior or action of depressed children and adults taking Paxil.
"I'm not sure it was done the exact Columbia way," Woodcock said.
Dr. Wayne K. Goodman, chair of the joint meeting of two federal advisory panels that called for the black-box warnings, said the new analysis could make it easier to see trends among young adults.
"We drew the line at 18," Goodman said. "But some of the same mechanisms that could be responsible for suicidality in a small fraction of patients would be operative in people who are 19, 20, 21. Who is to say?"
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On the Net:
Food and Drug Administration: http://www.fda.gov
© 2004 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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